Know the basics

What is acute appendicitis?

Acute appendicitis is inflammation of the appendix, the narrow, finger-shaped organ that branches off the first part of the large intestine on the right side of the abdomen. Although the appendix is a vestigial organ with no known function, it can become diseased. In fact, acute appendicitis is the most common reason for abdominal surgery in the world.

If it is not treated promptly, there is the chance that the inflamed appendix will burst, spilling fecal material into the abdominal cavity. The usual result is a potentially life-threatening infection (peritonitis), but the infection may become sealed off and form an abscess.

How common is acute appendicitis?

Acute appendicitis is extremely common. It commonly affects more males than females. It can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of acute appendicitis?

The common symptoms of acute appendicitis are:

Vague discomfort or tenderness near the navel (early in an attack), migrating to the right lower quadrant of the abdomen

Sharp, localized, persistent pain within a few hours

Pain that worsens with movement, deep breathing, coughing, sneezing, walking or being touched

Constipation and inability to pass gas, possibly alternating with diarrhea

Abrupt cessation of abdominal pain after other symptoms occur, indicating the appendix has burst – an emergency

Nausea and vomiting (in some cases)

Loss of appetite

Coated tongue and bad breath

Painful and/or frequent urination

Blood in the urine

Abdominal swelling or bloating, especially in infants

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes acute appendicitis?

Appendicitis is usually caused by a bacterial infection, although the reason the appendix becomes infected is unknown.

The appendix may become obstructed by a lump of feces, calcium salts, and fecal debris (called fecaliths) or tumors (rarely), leading to inflammation and infection.

Swelling and inflammation lead to infection, blood clot, or rupture of the appendix.

Lymphoid hyperplasia is associated with inflammatory and infectious disorders such as Crohn’s disease, measles, amebiasis, gastroenteritis, respiratory infections, and mononucleosis.

Risk factors

What increases my risk for acute appendicitis?

There are many risk factors for acute appendicitis, such as:

Having a family history of appendicitis

Being a male

Being between the ages of 10 and 19 years old

Having a long-lasting inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis

Research also suggests that the typical “Western diet,” which is high in carbohydrates and low in fiber, can increase your chances of developing appendicitis. Without enough fiber in your diet, bowel movements slow down, increasing the risk of appendix obstruction.

There is also a link between air pollution – in particular, high levels of ozone – and appendicitis. Scientists aren’t sure why air pollution is associated with an increased risk of appendicitis, but it may be that high levels of ozone increase intestinal inflammation or alter the normal communities of microbes in the gut.

Indeed, studies suggests that people get appendicitis more during the summer than other times of the year, likely due to a combination of increased air pollution, more GI infections, and greater consumption of fast food and other high-carb, low-fiber meals.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is acute appendicitis diagnosed?

Physical examination is necessary to rule out other disorders that produce symptoms similar to those of appendicitis. Your doctor will begin by performing a physical exam. A physical exam for appendicitis looks for tenderness in the lower right quadrant of your abdomen. If you’re pregnant, the pain may be higher. If perforation occurs, your stomach may become hard and swollen.

A swollen, rigid belly is a symptom that should be discussed with a doctor right away.

In addition to looking for tenderness, your doctor will perform several tests for appendicitis:

Urinalysis can rule out a urinary tract infection or kidney stone.

Pelvic exams can make certain that women don’t have reproductive problems. They can also rule out other pelvic infections.

Pregnancy tests can rule out a suspected ectopic pregnancy.

Abdominal imaging can determine if you have an abscess or other complications. This may be done with an X-ray, ultrasound, or CT scan.

Chest X-ray can rule out right lower lobe pneumonia. This sometimes has symptoms similar to appendicitis.

How is acute appendicitis treated?

Treatment for appendicitis varies.

In rare cases, appendicitis may get better without surgery. Treatment might involve only antibiotics and a liquid diet.

In most cases, however, surgery will be necessary. The type of surgery will depend on the details of your case.

If you have an abscess that hasn’t ruptured, you may receive antibiotics first. Your doctor will then drain your abscess using a tube placed through your skin. Surgery will remove your appendix after you’ve received treatment for the infection.

If you have a ruptured abscess or appendix, surgery may be necessary right away. Surgery to remove the appendix is known as an appendectomy.

A doctor can perform this procedure as open surgery or through a laparoscopy. Laparoscopy is less invasive, making the recovery time shorter. However, open surgery may be necessary if you have an abscess or peritonitis.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage acute appendicitis?

The following lifestyles and home remedies might help you cope with acute appendicitis:

Avoid strenuous activity at first. If your appendectomy was done laparoscopically, limit your activity for three to five days. If you had an open appendectomy, limit your activity for 10 to 14 days. Always ask your doctor about limitations on your activity and when you can resume normal activities following surgery.

Support your abdomen when you cough. Place a pillow over your abdomen and apply pressure before you cough, laugh or move to help reduce pain.

Get up and move when you’re ready. Start slowly and increase your activity as you feel up to it. Start with short walks.

Sleep when tired. As your body heals, you may find you feel sleepier than usual. Take it easy and rest when you need to.

Discuss returning to work or school with your doctor. You can return to work when you feel up to it. Children may be able to return to school less than a week after surgery. They should wait two to four weeks to resume strenuous activity, such as gym classes or sports.

If you have any questions, please consult with your doctor to better understand the best solution for you.